Objective To use direct dilution method to pretreat human urine, and to determine 19 elements in human urine using inductively coupled plasma mass spectrometry, and to evaluate the uncertainty of the entire experimental process. Methods The relevant mathematical models were established according to JJF 10591-2012 ^“Evaluation and Expression of Measurement Uncertainty^” and CNAS-GL006 ^“Guidance for Evaluation of Uncertainty in Chemical Analysis^”. Taking molybdenum as an example, the uncertainty sources in the determination of 19 elements in human urine by inductively coupled plasma method were analyzed and evaluated, including sample pretreatment, sample repeated measurement, standard solution preparation and standard curve fitting. Results The extended uncertainty of molybdenum in human urine is 2.12μg/L, and the measurement result of molybdenum is (44.8±2.12)μg/L. The measurement result of 19 elements in human urine ranges from less than the detection limit to 601μg/L, and the extended uncertainty range is 0.38~33.6μg/L.Conclusion It was found from the calculation that the uncertainty of the determination result was mainly affected by the uncertainty of the sample repeated measurement and the standard curve fitting. By adjusting the range of standard curve and increasing the number of parallel sample measurement, the uncertainty was reduced and the quality of detection was improved.

OBJECTIVE To explore comprehensive management and potential issues associated with long-term prescriptions medications of psychiatry， in order to provide a reference for the comprehensive management of long-term prescriptions of psychiatry in psychiatric hospitals and other medical institutions’ pharmacies. METHODS Starting from the applicable principles for long-term prescriptions of psychiatry， this study introduced the standardized assessment and precautions before issuing long-term prescriptions， the formulation and adjustment of the drug list， as well as the rational management of the long-term prescriptions. It also analyzed potential issues that may arise in the comprehensive management of long-term prescription medications and proposed corresponding countermeasures and suggestions. RESULTS & CONCLUSIONS Prior to initiating long-term prescriptions， a standardized assessment should be conducted on patients from the aspects of their psychiatric condition and long-term potential risk factors， pharmacological treatment plans and other non-pharmacological therapies， physical illnesses. Additionally， healthcare providers should fulfill their obligation to inform patients or their family members. The comprehensive management of long-term prescription medications should be jointly established and improved by multiple departments， and the formulation of drug catalogs should avoid including drugs with potential social harm or medication risks while complying with policy requirements. Furthermore， measures such as adding special identifiers to long-term prescriptions， providing patients with reminders about （No.YGLX202537） prescription expiration， or offering online consultations can also effectively enhance the rationality of medication use under long-term prescriptions. Currently， the implementation of long-term prescriptions in psychiatry remains challenged by inconsistencies in prescription duration， incomplete coverage of diagnostic categories， poor patient adherence， and the risk of deviation in clinical assessments. In this regard， measures such as collaborating with multiple departments to strengthen long-term prescription information management， providing matching pharmaceutical services， ensuring the quality and rationality of long-term prescription implementation， and using modern methods to screen high-risk patients can be taken to improve patient medication compliance and safety.

In the context of aging population, the issue of polypharmacy among elderly patients with mental disorders has become increasingly prominent.Cognitive decline and depressive symptoms render these patients more vulnerable to medication-related risks, while poorly managed physical illnesses further complicate their treatment.To address these challenges, this paper proposes a series of management strategies that emphasize the critical role of pharmacists in conducting medication reviews.A comprehensive assessment of drug risks, benefits, and patient adherence is essential.The proposed strategies not only require careful consideration of patients' clinical needs and individual preferences but also highlight the importance of multidisciplinary team collaboration to reach a consensus on medication therapy.The use of clinical decision support systems as an auxiliary tool is recommended to enhance the scientific rigor of medication decision-making.Furthermore, pharmacists can optimize medication regimens through scientifically validated methods and promote patient or family involvement in self-management to improve acceptance and adherence to treatment adjustments.

Background and Aims:Triple-negative breast cancer(TNBC)is a clinically aggressive subtype of breast cancer with limited treatment options.Immune checkpoint blockade(ICB)combined with chemotherapy has emerged as a key neoadjuvant therapeutic strategy for TNBC.However,significant variability in ICB efficacy exists among patients,and the underlying mechanisms related to the tumor immune microenvironment(TME)remain unclear.Cancer-associated fibroblasts(CAFs),as major stromal components,regulate TME and influence immunotherapy responses.Fibroblast activation protein(FAP),a key marker of CAFs,has been associated with poor prognosis in multiple solid tumors,yet its immunological role in TNBC has not been systematically investigated.This study aims to elucidate the expression pattern of FAP in TNBC,its impact on the immune microenvironment and ICB efficacy,and to explore its potential immunosuppressive mechanisms and clinical implications.Methods:The data from TCGA and the I-SPY2 clinical trial were integrated to assess the association of FAP expression with prognosis,immune cell infiltration,and immune checkpoint molecule expression in TNBC.Immune landscape profiling was conducted using CIBERSORT,GSEA enrichment analysis,and differential gene expression analysis(DESeq2)to characterize the immune features associated with FAP expression and to identify downstream genes at the transcriptomic level.CAF models with FAP overexpression or knockdown were constructed and co-cultured with CD8? T cells to evaluate FAP's regulatory effects on CD8? T cell activity and apoptosis.The expression of COL1A1,a potential FAP-regulated gene identified from transcriptomic analysis,was validated using qPCR and Western blot.Finally,clinical data and multiplex immunofluorescence pathology samples from TNBC patients at Xiangya Hospital were analyzed alongside I-SPY2 data to determine the predictive value of FAP expression for pathological complete response(pCR)following neoadjuvant immunotherapy.Results:FAP was significantly upregulated in TNBC tumor tissues compared to normal tissues and associated with shorter overall survival.Multivariate Cox regression analysis identified FAP as an independent adverse prognostic factor.High FAP expression was correlated with reduced infiltration of CD8? T cells,NK cells,and Tfh cells,as well as upregulation of immune checkpoints including CD276,TIM-3,and PD-L2.In CAF models,FAP overexpression suppressed CD8? T cell activity and promoted apoptosis,while FAP knockdown had the opposite effect.Transcriptomic analysis showed that COL1A1 and other collagen-related genes were significantly upregulated in the FAP-high group and positively correlated with FAP expression;qPCR and Western blot confirmed that FAP positively regulates COL1A1 expression.Analysis of I-SPY2 data revealed that FAP-low patients receiving pembrolizumab plus chemotherapy had significantly higher pCR rates compared to FAP-high patients.Consistently,clinical data from the Xiangya cohort showed reduced CD8? T cell infiltration and lower pCR rates in FAP-high patients,with a ROC AUC of 0.857 for predicting treatment response.Conclusion:FAP-high CAFs contribute to the formation of an immunosuppressive TME in TNBC by promoting COL1A1 secretion,inhibiting CD8? T cell function,and upregulating immune checkpoint molecules.High FAP expression is associated with poor prognosis and reduced response to immunotherapy,highlighting FAP as both a prognostic biomarker and a potential therapeutic target for stratified and combination treatment strategies in TNBC.

Public hospitals have formed a relatively perfect working foundation in the introduction and training of young talents,but the evaluation system of young talents is not perfect.Based on the requirements of high-quality development,grasp the principle of party management of talents,combine the talents development situation in Jiading District Maternal and Child Health Care Hospital,takes the special training of young talents in administration as the starting point,comprehensively uses the literature method,interview method and Delphi method to establish the index database,uses the exploratory factor analysis meth-od to calculate the index weight,and constructs the evaluation model of young talents in hospital administrative management,so as to help hospitals better screen and evaluate talents and give full play to the value and role of talents as the first resource.

Background and Aims:Triple-negative breast cancer(TNBC)is a clinically aggressive subtype of breast cancer with limited treatment options.Immune checkpoint blockade(ICB)combined with chemotherapy has emerged as a key neoadjuvant therapeutic strategy for TNBC.However,significant variability in ICB efficacy exists among patients,and the underlying mechanisms related to the tumor immune microenvironment(TME)remain unclear.Cancer-associated fibroblasts(CAFs),as major stromal components,regulate TME and influence immunotherapy responses.Fibroblast activation protein(FAP),a key marker of CAFs,has been associated with poor prognosis in multiple solid tumors,yet its immunological role in TNBC has not been systematically investigated.This study aims to elucidate the expression pattern of FAP in TNBC,its impact on the immune microenvironment and ICB efficacy,and to explore its potential immunosuppressive mechanisms and clinical implications.Methods:The data from TCGA and the I-SPY2 clinical trial were integrated to assess the association of FAP expression with prognosis,immune cell infiltration,and immune checkpoint molecule expression in TNBC.Immune landscape profiling was conducted using CIBERSORT,GSEA enrichment analysis,and differential gene expression analysis(DESeq2)to characterize the immune features associated with FAP expression and to identify downstream genes at the transcriptomic level.CAF models with FAP overexpression or knockdown were constructed and co-cultured with CD8? T cells to evaluate FAP's regulatory effects on CD8? T cell activity and apoptosis.The expression of COL1A1,a potential FAP-regulated gene identified from transcriptomic analysis,was validated using qPCR and Western blot.Finally,clinical data and multiplex immunofluorescence pathology samples from TNBC patients at Xiangya Hospital were analyzed alongside I-SPY2 data to determine the predictive value of FAP expression for pathological complete response(pCR)following neoadjuvant immunotherapy.Results:FAP was significantly upregulated in TNBC tumor tissues compared to normal tissues and associated with shorter overall survival.Multivariate Cox regression analysis identified FAP as an independent adverse prognostic factor.High FAP expression was correlated with reduced infiltration of CD8? T cells,NK cells,and Tfh cells,as well as upregulation of immune checkpoints including CD276,TIM-3,and PD-L2.In CAF models,FAP overexpression suppressed CD8? T cell activity and promoted apoptosis,while FAP knockdown had the opposite effect.Transcriptomic analysis showed that COL1A1 and other collagen-related genes were significantly upregulated in the FAP-high group and positively correlated with FAP expression;qPCR and Western blot confirmed that FAP positively regulates COL1A1 expression.Analysis of I-SPY2 data revealed that FAP-low patients receiving pembrolizumab plus chemotherapy had significantly higher pCR rates compared to FAP-high patients.Consistently,clinical data from the Xiangya cohort showed reduced CD8? T cell infiltration and lower pCR rates in FAP-high patients,with a ROC AUC of 0.857 for predicting treatment response.Conclusion:FAP-high CAFs contribute to the formation of an immunosuppressive TME in TNBC by promoting COL1A1 secretion,inhibiting CD8? T cell function,and upregulating immune checkpoint molecules.High FAP expression is associated with poor prognosis and reduced response to immunotherapy,highlighting FAP as both a prognostic biomarker and a potential therapeutic target for stratified and combination treatment strategies in TNBC.

Public hospitals have formed a relatively perfect working foundation in the introduction and training of young talents,but the evaluation system of young talents is not perfect.Based on the requirements of high-quality development,grasp the principle of party management of talents,combine the talents development situation in Jiading District Maternal and Child Health Care Hospital,takes the special training of young talents in administration as the starting point,comprehensively uses the literature method,interview method and Delphi method to establish the index database,uses the exploratory factor analysis meth-od to calculate the index weight,and constructs the evaluation model of young talents in hospital administrative management,so as to help hospitals better screen and evaluate talents and give full play to the value and role of talents as the first resource.

In the context of aging population, the issue of polypharmacy among elderly patients with mental disorders has become increasingly prominent.Cognitive decline and depressive symptoms render these patients more vulnerable to medication-related risks, while poorly managed physical illnesses further complicate their treatment.To address these challenges, this paper proposes a series of management strategies that emphasize the critical role of pharmacists in conducting medication reviews.A comprehensive assessment of drug risks, benefits, and patient adherence is essential.The proposed strategies not only require careful consideration of patients' clinical needs and individual preferences but also highlight the importance of multidisciplinary team collaboration to reach a consensus on medication therapy.The use of clinical decision support systems as an auxiliary tool is recommended to enhance the scientific rigor of medication decision-making.Furthermore, pharmacists can optimize medication regimens through scientifically validated methods and promote patient or family involvement in self-management to improve acceptance and adherence to treatment adjustments.

Objective To investigate the effects of atorvastatin calcium on thyroid function, immune response and C-Jun N-terminal kinase/p38 mitogen-activated protein kinase (JNK/p38 MAPK) signaling pathway in rats with hypothyroidism. Methods A total of 30 healthy adult male SD rats were randomly divided into control group, hypothyroid group (PTU group) and atorvastatin calcium treatment group (ACT group), with 10 rats in each group. Rats in the PTU group and the ACT group were injected with PTU subcutaneously at the dorsum of the neck every day for 28 consecutive days; instead of PTU, rats in the control group were injected subcutaneously with 0.3 mL of saline. After 2 weeks of PTU treatment, rats in the ACT group were gavaged with 3 mL of atorvastatin calcium saline solution (containing 5 mg/kg of atorvastatin calcium), which was administered once daily; the control group was gavaged with an equal amount of saline in the same way. The body weight, food intake and water intake of rats were measured weekly. The histopathological changes of the thyroid gland were observed in histopathological sections of rats in each group. Enzyme-linked immunosorbent assay (ELISA) was performed to determine the levels of triiodothyronine (T3), thyroxine (T4), thyroid stimulating hormone (TSH), interferon γ (IFN-γ) and interleukin-4 (IL-4) in serum; quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) was performed to detect the mRNA expression levels of IFN-γ, IL-10, Foxp3 and IL-4; western blot was performed to determine the levels of p-JNK/JNK and p-p38/p38 MAPK. Results Compared with control group, PTU-induced hypothyroidism rats showed a significant decrease in body mass and food and water consumption (P < 0.05). After 2 weeks of treatment with atorvastatin calcium, the body mass loss of PTU rats was inhibited, food and water consumption was improved, and the differences were statistically significant (P < 0.05). Atorvastatin calcium was able to significantly increase the serum T3 and T4 levels and decrease the serum TSH level in hypothyroid rats (P < 0.05). Atorvastatin calcium treatment was able to significantly alleviate histopathological changes such as follicular cell proliferation and related hypertrophy induced by PTU, and increase follicular size (P < 0.05). After treatment with atorvastatin calcium, the spleen mass of PTU rats increased significantly, and the expression of IFN-γ mRNA in hypothyroid rats decreased significantly, but the expression levels of IL-10 mRNA, Foxp3 mRNA and IL-4 mRNA increased significantly (P < 0.05). After treatment with atorvastatin calcium, the levels of p-JNK/JNK and p-p38/p38 MAPK in thyroid tissue of hypothyroid rats decreased significantly (P < 0.05). Conclusion Atorvastatin calcium treatment for hypothyroidism has the function of promoting the normalization of thyroid hormone imbalance, balancing Th1/Th2 cytokines, and inhibiting the activation of JNK/p38 MAPK signaling pathway.

Objective:To explore the application effects of the goal-oriented teaching method based on mind mapping in the teaching of stomatology practical courses.Methods:From September 2022 to September 2023, 52 fourth-year students of clinical stomatology at Harbin Medical University were divided into test group and control group for practical teaching, with 26 cases in each group. The test group received goal-oriented teaching based on mind mapping, while the control group received traditional teaching, for 20 class hours in both groups. The two groups were compared in terms of general data, theoretical and practical assessment scores, the score of the self-rating scale of self-directed learning (SRSSDL) and the score of critical thinking disposition inventory-Chinese version (CTDI-CV) before and after training, and student satisfaction with teaching activities. SPSS 25.0 software was used to perform the t-test or χ2 test. Results:After completing the practical training courses, the test group showed significantly higher scores than the control group in multiple-choice questions [(16.85±1.39) vs. (15.33±2.21)], fill-in-the-blank questions [(17.21±1.98) vs. (16.01±2.02)], short answer questions [(17.47±2.27) vs. (15.23±2.45)], case analysis [(34.36±2.79) vs. (32.57±3.02)], and practical assessment [(84.69±4.73) vs. (80.57±4.21)] (all P<0.05). The SRSSDL score and CTDI-CV score were improved in both groups, and were significantly higher in the test group [(215.29±10.42) and (357.49±17.80)] than in the control group [(200.23±11.42) and (342.23±17.26)] (both P<0.05). The students of the test group were significantly more satisfied with teaching activities than those of the control group ( P<0.05). Conclusions:Compared with the traditional teaching method, the goal-oriented teaching method based on mind mapping is more effective in stomatology practical teaching, which can improve students' self-directed learning ability and critical thinking ability, promote their mastery of theoretical knowledge, enhance their clinical practice ability, and increase their satisfaction with teaching activities.